Blood stream infections in patients in the burn intensive care unit

Hun Gu Lee, Juah Jang, Jeong Eun Choi, Doo Cheol Chung, Jung Wan Han, Heungjeong Woo, Wook Jeon, Byung-Chul Chun

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Background: The study on bacteremia helps empirically select the proper antibiotics before the results of culture test about causative pathogen. The purpose of this study is to investigate causative pathogen in bloodstream infection, changing aspects based on elapsed time after burn, relationship with other sites and resistance of important causative pathogen against antibiotics through analysis on bacteria isolated from blood culture of patients hospitalized in burn intensive care unit (BICU). Materials and Methods: A retrospective study was conducted targeting patients hospitalized in BICU from January 2007 to June 2011. Changes of causative pathogen in bloodstream infection based on elapsed time after injury were analyzed. We would like to examine the relationship between bloodstream infection and infection on other body parts by comparing results of cultures in burn wound site, sputum, urine and catheter tip. Antibiotics resistance patterns of Pseudomonas aeruginosa, Acinetobacter baumannii, Staphylococcus aureus, Enterococcus species, and Klebsiella pneumoniae were studied. Results: A total of 2,337 burn patients were hospitalized in BICU for 54 months. Causative pathogen was cultured in blood cultures from 397 patients (17.0%). P. aeruginosa (169, 30.1%) was the most cultured and A. baumannii (107, 19.0%) and S. aureus (81, 14.4%) were followed. It was confirmed that the relative frequency of A. baumannii tended to get lower as the period got longer after injury, but the relative frequency of K. pneumoniae got higher as the period got longer after injury. With comparison without bacteremia, P. aeruginosa bacteremia showed high probability in which the same bacteria were cultured in wound site, sputum and cathether tip, and A. baumannii bacteremia and candida bacteremia had high probability in sputum, and urine and catheter tip, respectively. 95.9% of P. aeruginosa and 95.3% of A. baumannii showed the resistance against carbapenem. 96.3% of S. aureus was methicillin resistant and 36.2% of Enterococcus species were vancomycin resistant. 75.0% of K. pneumonia were extended-spectrum beta-lactamase (ESBL)-producing bacteria. Conclusions: Since the highly antibiotic resistant microorganisms were isolated from the patients hospitalized in BICU during early phase, the empirical selection of antibiotics targeting these pathogens should be considered before the results of microbiologic culture test. In addition, use of empirical antifungal agent after 1 week of injury can be considered for patients who have risk factor of fungal infection.

Original languageEnglish
Pages (from-to)194-201
Number of pages8
JournalInfection and Chemotherapy
Volume45
Issue number2
DOIs
Publication statusPublished - 2013 Sep 23

Fingerprint

Acinetobacter baumannii
Intensive Care Units
Bacteremia
Pseudomonas aeruginosa
Wounds and Injuries
Infection
Sputum
Anti-Bacterial Agents
Enterococcus
Klebsiella pneumoniae
Bacteria
Staphylococcus aureus
Catheters
Urine
Carbapenems
Mycoses
Antifungal Agents
Vancomycin
beta-Lactamases
Methicillin-Resistant Staphylococcus aureus

Keywords

  • Blood stream infection
  • Burn
  • ICU

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Blood stream infections in patients in the burn intensive care unit. / Lee, Hun Gu; Jang, Juah; Choi, Jeong Eun; Chung, Doo Cheol; Han, Jung Wan; Woo, Heungjeong; Jeon, Wook; Chun, Byung-Chul.

In: Infection and Chemotherapy, Vol. 45, No. 2, 23.09.2013, p. 194-201.

Research output: Contribution to journalArticle

Lee, HG, Jang, J, Choi, JE, Chung, DC, Han, JW, Woo, H, Jeon, W & Chun, B-C 2013, 'Blood stream infections in patients in the burn intensive care unit', Infection and Chemotherapy, vol. 45, no. 2, pp. 194-201. https://doi.org/10.3947/ic.2013.45.2.194
Lee, Hun Gu ; Jang, Juah ; Choi, Jeong Eun ; Chung, Doo Cheol ; Han, Jung Wan ; Woo, Heungjeong ; Jeon, Wook ; Chun, Byung-Chul. / Blood stream infections in patients in the burn intensive care unit. In: Infection and Chemotherapy. 2013 ; Vol. 45, No. 2. pp. 194-201.
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abstract = "Background: The study on bacteremia helps empirically select the proper antibiotics before the results of culture test about causative pathogen. The purpose of this study is to investigate causative pathogen in bloodstream infection, changing aspects based on elapsed time after burn, relationship with other sites and resistance of important causative pathogen against antibiotics through analysis on bacteria isolated from blood culture of patients hospitalized in burn intensive care unit (BICU). Materials and Methods: A retrospective study was conducted targeting patients hospitalized in BICU from January 2007 to June 2011. Changes of causative pathogen in bloodstream infection based on elapsed time after injury were analyzed. We would like to examine the relationship between bloodstream infection and infection on other body parts by comparing results of cultures in burn wound site, sputum, urine and catheter tip. Antibiotics resistance patterns of Pseudomonas aeruginosa, Acinetobacter baumannii, Staphylococcus aureus, Enterococcus species, and Klebsiella pneumoniae were studied. Results: A total of 2,337 burn patients were hospitalized in BICU for 54 months. Causative pathogen was cultured in blood cultures from 397 patients (17.0{\%}). P. aeruginosa (169, 30.1{\%}) was the most cultured and A. baumannii (107, 19.0{\%}) and S. aureus (81, 14.4{\%}) were followed. It was confirmed that the relative frequency of A. baumannii tended to get lower as the period got longer after injury, but the relative frequency of K. pneumoniae got higher as the period got longer after injury. With comparison without bacteremia, P. aeruginosa bacteremia showed high probability in which the same bacteria were cultured in wound site, sputum and cathether tip, and A. baumannii bacteremia and candida bacteremia had high probability in sputum, and urine and catheter tip, respectively. 95.9{\%} of P. aeruginosa and 95.3{\%} of A. baumannii showed the resistance against carbapenem. 96.3{\%} of S. aureus was methicillin resistant and 36.2{\%} of Enterococcus species were vancomycin resistant. 75.0{\%} of K. pneumonia were extended-spectrum beta-lactamase (ESBL)-producing bacteria. Conclusions: Since the highly antibiotic resistant microorganisms were isolated from the patients hospitalized in BICU during early phase, the empirical selection of antibiotics targeting these pathogens should be considered before the results of microbiologic culture test. In addition, use of empirical antifungal agent after 1 week of injury can be considered for patients who have risk factor of fungal infection.",
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